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 DISCOVER NEW GENES AND PATHWAYS  REFINING PHENOTYPES CAN HELP IN GENE IDENTIFICATION PHENOTYPESGENES PHENOTYPES GENES IDENTIFICATION OF GENES MAY HELP IN ISOLATING PHENOTYPIC ENTITIES  PHARMACOGENETICS TO IMPROVE THE ADAPTATION OF THE TREATMENT TO THE INDIVIDUALIZED PATIENT  PREDICTIVE MEDICINE? GENOTYPE/PHENOTYPE ANALYSIS

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Achievements in asthma genetics appear both impressive and confusing. Many susceptibility genes are robust candidates, new genes have been discovered leading to new hypothesis (functional role?) Replication of previous results of linkage and associations has been generally poor. Asthma is a complex disease, with implication of multiple genes of small effects with modulation of expression (gene and/or environment interactions). importance of careful definition of phenotypes and environmental exposures Studies are expensive

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Achievements in asthma genetics appear both impressive and confusing Due to strong gene/environment interactions, careful assessments of environmental factors are necessary. Link all the available data from geneticists, biologists, clinicians, epidemiologists Necessity of analysis taking into account the whole system biology: genome, but also transcriptome and proteome MEDICINA OMICA

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PEDIATRIC ASTHMA DEATHS MILD PATIENTS ARE ALSO AT RISK Patients Deaths (%) Finding from a cohort study reviewing all pediatric asthma-related deaths in the Australian state of Victoria Robertson C. et al. Pediatric Pulmology, 1992; 13: Patient Assessment  SAA may occur in asthmatics classified as mild, moderate or severe  Some patients (or family members) may report excessive allergen exposure, or be unware of such an exposure even if such an exposure seemed to play an important role in the fatal attack